Smoking and Transplant Candidacy — ESENeph MCQ

Correct answer: A — Continue risk assessment, cessation support and individualized candidacy review

The best answer is “Continue risk assessment, cessation support and individualized candidacy review”. KDIGO supports cessation and risk modification. Active tobacco use raises perioperative and long-term risk, but a former smoker is assessed on current health and residual risk rather than excluded forever. “Defer candidacy pending sustained smoking cessation and risk reassessment” is less appropriate because candidate assessment is individualized and past exposure is not a universal absolute contraindication “Proceed to listing after documenting recent smoking cessation” is less appropriate because cardiovascular, pulmonary and malignancy risk remain clinically relevant “Complete cardiovascular assessment before deciding transplant candidacy” is less appropriate because heavy exposure strengthens the need for appropriate risk assessment “Require ten years of abstinence before transplant referral” is less appropriate because KDIGO does not impose this universal interval

Reference: KDIGO transplant-candidate guideline: https://kdigo.org/guidelines/transplant-candidate/